Showing papers by "Freddie Bray published in 2012"
TL;DR: Application of existing public health methods for infection prevention, such as vaccination, safer injection practice, or antimicrobial treatments, could have a substantial effect on the future burden of cancer worldwide.
Abstract: Summary Background Infections with certain viruses, bacteria, and parasites have been identified as strong risk factors for specific cancers. An update of their respective contribution to the global burden of cancer is warranted. Methods We considered infectious agents classified as carcinogenic to humans by the International Agency for Research on Cancer. We calculated their population attributable fraction worldwide and in eight geographical regions, using statistics on estimated cancer incidence in 2008. When associations were very strong, calculations were based on the prevalence of infection in cancer cases rather than in the general population. Estimates of infection prevalence and relative risk were extracted from published data. Findings Of the 12·7 million new cancer cases that occurred in 2008, the population attributable fraction (PAF) for infectious agents was 16·1%, meaning that around 2 million new cancer cases were attributable to infections. This fraction was higher in less developed countries (22·9%) than in more developed countries (7·4%), and varied from 3·3% in Australia and New Zealand to 32·7% in sub-Saharan Africa. Helicobacter pylori , hepatitis B and C viruses, and human papillomaviruses were responsible for 1·9 million cases, mainly gastric, liver, and cervix uteri cancers. In women, cervix uteri cancer accounted for about half of the infection-related burden of cancer; in men, liver and gastric cancers accounted for more than 80%. Around 30% of infection-attributable cases occur in people younger than 50 years. Interpretation Around 2 million cancer cases each year are caused by infectious agents. Application of existing public health methods for infection prevention, such as vaccination, safer injection practice, or antimicrobial treatments, could have a substantial effect on the future burden of cancer worldwide. Funding Fondation Innovations en Infectiologie (FINOVI) and the Bill & Melinda Gates Foundation (BMGF).
2,083 citations
TL;DR: The findings suggest that rapid societal and economic transition in many countries means that any reductions in infection-related cancers are offset by an increasing number of new cases that are more associated with reproductive, dietary, and hormonal factors.
Abstract: Summary Background Cancer is set to become a major cause of morbidity and mortality in the coming decades in every region of the world. We aimed to assess the changing patterns of cancer according to varying levels of human development. Methods We used four levels (low, medium, high, and very high) of the Human Development Index (HDI), a composite indicator of life expectancy, education, and gross domestic product per head, to highlight cancer-specific patterns in 2008 (on the basis of GLOBOCAN estimates) and trends 1988–2002 (on the basis of the series in Cancer Incidence in Five Continents), and to produce future burden scenario for 2030 according to projected demographic changes alone and trends-based changes for selected cancer sites. Findings In the highest HDI regions in 2008, cancers of the female breast, lung, colorectum, and prostate accounted for half the overall cancer burden, whereas in medium HDI regions, cancers of the oesophagus, stomach, and liver were also common, and together these seven cancers comprised 62% of the total cancer burden in medium to very high HDI areas. In low HDI regions, cervical cancer was more common than both breast cancer and liver cancer. Nine different cancers were the most commonly diagnosed in men across 184 countries, with cancers of the prostate, lung, and liver being the most common. Breast and cervical cancers were the most common in women. In medium HDI and high HDI settings, decreases in cervical and stomach cancer incidence seem to be offset by increases in the incidence of cancers of the female breast, prostate, and colorectum. If the cancer-specific and sex-specific trends estimated in this study continue, we predict an increase in the incidence of all-cancer cases from 12·7 million new cases in 2008 to 22·2 million by 2030. Interpretation Our findings suggest that rapid societal and economic transition in many countries means that any reductions in infection-related cancers are offset by an increasing number of new cases that are more associated with reproductive, dietary, and hormonal factors. Targeted interventions can lead to a decrease in the projected increases in cancer burden through effective primary prevention strategies, alongside the implementation of vaccination, early detection, and effective treatment programmes. Funding None.
1,792 citations
TL;DR: PCa incidence rates increased in nearly all countries considered in this analysis except in a few high-income countries, and the increase in PCa mortality rates mainly occurred in lower resource settings, with declines largely confined to high-resource countries.
1,362 citations
TL;DR: Cervical cancer is the third most common female malignancy and shows a strong association with level of development, rates being at least four-fold higher in countries defined within the low ranking of the Human Development Index (HDI) compared with those in the very high category.
1,342 citations
TL;DR: This work aimed to quantify suicide mortality in India in 2010 by applying the age-specific and sex-specific proportion of suicide deaths in this survey to the 2010 UN estimates of absolute numbers of deaths in India.
780 citations
TL;DR: Age-adjusted DALYs lost from cancer are substantial, irrespective of world region, and consistently larger proportions of YLLs in low HDI than in high HDI countries indicate substantial inequalities in prognosis after diagnosis, related to degree of human development.
531 citations
TL;DR: The current patterns of cancer in Africa are reviewed and the opportunities for reducing the burden through the application of resource level interventions, including implementation of vaccinations for liver and cervical cancers, tobacco control policies for smoking‐related cancers, and low‐tech early detection methods for cervical cancer are reviewed.
Abstract: Cancer is an emerging public health problem in Africa. About 715,000 new cancer cases and 542,000 cancer deaths occurred in 2008 on the continent, with these numbers expected to double in the next 20 years simply because of the aging and growth of the population. Furthermore, cancers such as lung, female breast, and prostate cancers are diagnosed at much higher frequencies than in the past because of changes in lifestyle factors and detection practices associated with urbanization and economic development. Breast cancer in women and prostate cancer in men have now become the most commonly diagnosed cancers in many Sub-Saharan African countries, replacing cervical and liver cancers. In most African countries, cancer control programs and the provision of early detection and treatment services are limited despite this increasing burden. This paper reviews the current patterns of cancer in Africa and the opportunities for reducing the burden through the application of resource level interventions, including implementation of vaccinations for liver and cervical cancers, tobacco control policies for smoking-related cancers, and low-tech early detection methods for cervical cancer, as well as pain relief at the palliative stage of cancer.
409 citations
93 citations
TL;DR: The incidence rates of HCC in urban Shanghai from 1976 to 2005 have declined in both sexes, with the complex but similar patterns observed in successive generations suggestive of a shared changing prevalence in risk factors in men and women.
Abstract: In China, hepatocellular carcinoma (HCC) incidence rates in several registry catchment populations are amongst the highest worldwide. The incidence rates in urban Shanghai were analyzed between 1976 and 2005 to describe and interpret the time trends. Age-specific and age-standardized rates were calculated and graphically presented. An age-period-cohort model was fitted to assess the effects of age at diagnosis, calendar period, and birth cohort on the changing HCC incidence rates. In total, 35,241 and 13,931 men and women were diagnosed with HCC during 1976–2005 in urban Shanghai. The age-standardized incidence rates in urban Shanghai were 33.9 per 105 among men and 11.4 per 105 among women in 1976–1980, but decreased in both sexes to 25.8 per 105 and 8.5 per 105, respectively by 2001–2005. Accelerating rates in birth cohorts born in the early-1930s and decelerating rates circa 1945 were observed in both sexes, with further accelerations noted in the late-1950s (in women) and early-1960s (in men). Given the parameterization, increases in risk of HCC were seen in successive male and female generations between 1900 and 1935, followed by a further increase among successive cohorts born around 1960, with a reduction in risk in the most recent generations. The incidence rates of HCC in urban Shanghai from 1976 to 2005 have declined in both sexes, with the complex but similar patterns observed in successive generations suggestive of a shared changing prevalence in risk factors in men and women, with a role possibly for HBV interventions reducing risk of HCC in cohorts born after 1960.
83 citations
TL;DR: A methodology that derives global DALYs and validate variables and DALS based on data from various cancer registries is proposed, enabling global estimates of DALys and international comparisons that support priorities in cancer control.
Abstract: Disability-adjusted life years (DALYs) link data on disease occurrence to health outcomes, and they are a useful aid in establishing country-specific agendas regarding cancer control. The variables required to compute DALYs are however multiple and not readily available in many countries. We propose a methodology that derives global DALYs and validate variables and DALYs based on data from various cancer registries. We estimated DALYs for four countries (Norway, Bulgaria, India and Uganda) within each category of the human development index (HDI). The following sources (indicators) were used: Globocan2008 (incidence and mortality), various cancer registries (proportion cured, proportion treated and duration of disease), treatment guidelines (duration of treatment), specific burden of disease studies (sequelae and disability weights), alongside expert opinion. We obtained country-specific population estimates and identified resource levels using the HDI, DALYs are computed as the sum of years of life lost and years lived with disabilities. Using mortality:incidence ratios to estimate country-specific survival, and by applying the human development index we derived country-specific estimates of the proportion cured and the proportion treated. The fit between the estimates and observed data from the cancer registries was relatively good. The final DALY estimates were similar to those computed using observed values in Norway, and in WHO’s earlier global burden of disease study. Marked cross-country differences in the patterns of DALYs by cancer sites were observed. In Norway and Bulgaria, breast, colorectal, prostate and lung cancer were the main contributors to DALYs, representing 54% and 45%, respectively, of the totals. These cancers contributed only 27% and 18%, respectively, of total DALYs in India and Uganda. Our approach resulted in a series of variables that can be used to estimate country-specific DALYs, enabling global estimates of DALYs and international comparisons that support priorities in cancer control.
64 citations
TL;DR: A population level improvement in survival is demonstrated among patients with oropharyngeal squamous cell cancers commonly related to infection with HPV, as well as patients with HNSCC not related to HPV, in the period 1981-2007.
TL;DR: Recent developments in the national cancer control agenda have included an increasing emphasis on outcome measures, with short-term cancer survival an operational measure of variation and progress in cancer control giving strong support for this strategy.
TL;DR: The incidence of breast cancer has increased in Mumbai during last two to three decades, with increases greater among older women, and the number of cases is predicted to double to over 2500 cases by 2025, the vast majority affecting older women.
TL;DR: The lack of decline in the mortality rates over time, while based on relatively few deaths, highlights a need for improvements in diagnostics and management of therapy in Croatia in order to improve the survival and quality-of-life of testicular cancer patients.
TL;DR: It is indicated that a small but important group of older patients present at a late stage and succumb early to their cancers, possibly in combination with severe comorbidity, and this situation is more common in England than in Norway or Sweden.
TL;DR: The paper presents comparison of trends in testicular cancer between the east and the west of Europe to highlight the need to understand more fully the heterogeneity of the disease.
Abstract: The paper presents comparison of trends in testicular cancer between the east and the west of Europe.
TL;DR: Based on the present analysis of the comparability, completeness, validity and timeliness of premalignant lesions of vulva and vagina, it is concluded that the Cancer Registry of Norway is able to monitor such premalign lesions satisfactorily.
Abstract: Background. A crucial factor concerning the utility of Cancer Registries is the data quality with respect to comparability, completeness, validity and timeliness. However, the data quality of the registration of premalignant lesions has rarely been addressed. High grade vulvar intraepithelial neoplasia (VIN) and vaginal intraepithelial neoplasia (VaIN) are premalignant lesions which may develop into cancer, and are often associated with infection with the human papillomarvirus (HPV). The aim was to evaluate the quality of registration of VIN and VaIN at the Cancer Registry of Norway (CRN). Material and methods. We re-collected all notifications with high grade VIN and VaIN diagnoses during 2002 to 2007 from pathology laboratories, and compared these to the data in the CRN database so as to quantitatively measure the completeness, validity and timeliness of the data. Results. Over the period 2002 to 2007 we estimated the completeness of the 1556 VIN and 297 VaIN notifications to be 95.0% and 92.9%,...
TL;DR: The surveillance data that India has, indicate quite clearly that HPV infection and associated cervical cancer risk in India is a substantive burden and clear health priority which can be addressed now by a combination of screening and vaccination.
Abstract: In their paper, Mattheij et al.1 propose that current epidemiological data do not justify human papillomavirus (HPV) vaccination in India. They state ‘current data on HPV type and cervical cancer incidence do not support [the] claim that India has a large burden of cervical cancer’. As the source of many of these data, we strongly contest this viewpoint.
Our GLOBOCAN 2008 estimates of the burden of cervical cancer in India indicate that the incidence rates are substantially in excess of those observed in, for example, the UK, where the authors are based and where there is a school-based vaccination programme (age standardized rates of 27 and 7 per 100,000, respectively).2 The national estimates for India have a complex derivation due to the need to adequately balance rural/urban populations in different geographical regions, but the methods are clear and reproducible.2
Cervical cancer is the most common or the second most common female cancer in data from the seven highest-quality Indian cancer registries.3 Our recent nationally representative mortality study based on verbal autopsies showed that, in 2010, cervical cancer was the leading fatal cancer among women aged 30–69 years in both rural and urban areas.4 Overall we estimate that over a quarter of the world's cervical cancer cases and over a third of the cervical cancer deaths occur in India.2
While we agree with Mattheij et al. that incidence rates are declining over time in some urban regions,3 this is mainly due to the impact of multiple social factors (family planning, education and socioeconomic improvement)5,6 combined with the developing programmes for screening and early detection.7
What is known about HPV and high-risk HPV prevalence in India would indicate that, rates are at the higher end of a global scale (exactly as for cervical cancer incidence) and, unlike in many other populations, tend to stay high in middle-age women.8 More than elsewhere, high-risk HPV types 16 and 18 predominate in invasive cancer9 indicating current vaccines would be very effective.
Cancer surveillance in India is incomplete and faces uncertainties in estimation. However, there are a large number of cancer registries and more data are available than for many other countries at a similar developmental level. The surveillance data that we have, indicate quite clearly that HPV infection and associated cervical cancer risk in India is a substantive burden and clear health priority which can be addressed now by a combination of screening and vaccination.